Refractory cervical dystonia, unresolve issue and therapeutic challenge: Follow-up of a case with surgical denervation combined with conservative treatments
Cervical dystonia is the most common focal dystonia affecting adults. It frequently causes postural control problems, neck pain and spasm attacks of the cervical musculature. One of the surgical options available is selective cervical denervation. We report the case of a 32-year-old patient with cer...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-06-01
|
| Series: | Interdisciplinary Neurosurgery |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214751923001792 |
| _version_ | 1827316634806648832 |
|---|---|
| author | Hugues Ghislain Atakla Abdou Aziz Diop Ibrahima Tine Basse Sall Thomas Kofi Dakurah Sagar Diop Aristide Donyo Coumba Saar Pape Sandène Ndiaye Alioune Badara THIAM Momar Code BA |
| author_facet | Hugues Ghislain Atakla Abdou Aziz Diop Ibrahima Tine Basse Sall Thomas Kofi Dakurah Sagar Diop Aristide Donyo Coumba Saar Pape Sandène Ndiaye Alioune Badara THIAM Momar Code BA |
| author_sort | Hugues Ghislain Atakla |
| collection | DOAJ |
| description | Cervical dystonia is the most common focal dystonia affecting adults. It frequently causes postural control problems, neck pain and spasm attacks of the cervical musculature. One of the surgical options available is selective cervical denervation. We report the case of a 32-year-old patient with cervical dystonia refractory to conservative treatment and an injection of botulinum toxin A, which was finally completed by bilateral selective cervical denervation, with considerable regression of cervical spasm at 16 months post-operatively.The clinical presentation of cervical dystonia includes abnormal movements or postural changes of the head, neck and shoulders caused by involuntary contractions of the cervical muscles. When the spasmodic attacks are recurrent, they can cause real handicaps for the patient. The causes of the disease and its pathophysiological mechanism are still poorly understood. There are a number of treatment options, including pharmacological therapy and surgery in cases of therapeutic failure. Repeated intramuscular injections of botulinum toxin are the first-line treatment. Some conservative measures such as physiotherapy are also used, although there is little literature on these approaches.Selective peripheral denervation is currently the main surgical treatment for refractory cervical dystonia. A combination of conservative treatment with BT-A injection and denervation appears to be an effective treatment option. |
| first_indexed | 2024-03-09T03:11:28Z |
| format | Article |
| id | doaj.art-e75b205804e74c40981dd2a42d6ad25e |
| institution | Directory Open Access Journal |
| issn | 2214-7519 |
| language | English |
| last_indexed | 2024-04-24T23:17:53Z |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Interdisciplinary Neurosurgery |
| spelling | doaj.art-e75b205804e74c40981dd2a42d6ad25e2024-03-17T07:54:07ZengElsevierInterdisciplinary Neurosurgery2214-75192024-06-0136101896Refractory cervical dystonia, unresolve issue and therapeutic challenge: Follow-up of a case with surgical denervation combined with conservative treatmentsHugues Ghislain Atakla0Abdou Aziz Diop1Ibrahima Tine2Basse Sall3Thomas Kofi Dakurah4Sagar Diop5Aristide Donyo6Coumba Saar7Pape Sandène Ndiaye8Alioune Badara THIAM9Momar Code BA10Neurosurgery Department, Fann’s National Teaching Hospital Center, Dakar, Senegal; Neurosurgery Department, Principal Military Hospital, Dakar, Senegal; Laboratory of Noncommunicable and Neurologic Diseases Epidemiology, Faculty of Health Science, University of Abomey-Calavi, Cotonou, Benin; Corresponding author at: Neurosurgery Department, Fann’s National Teaching Hospital Center, Dakar, Senegal.Neurosurgery Department, Fann’s National Teaching Hospital Center, Dakar, SenegalNeurosurgery Department, Fann’s National Teaching Hospital Center, Dakar, SenegalNeurosurgery Department, Fann’s National Teaching Hospital Center, Dakar, SenegalNeurosurgery Department, Korle-bu Teaching Hospital, Accra, GhanaNeurosurgery Department, Fann’s National Teaching Hospital Center, Dakar, SenegalNeurosurgery Department, Fann’s National Teaching Hospital Center, Dakar, SenegalNeurosurgery Department, Fann’s National Teaching Hospital Center, Dakar, SenegalNeurosurgery Department, Fann’s National Teaching Hospital Center, Dakar, Senegal; Neurosurgery Department, Principal Military Hospital, Dakar, SenegalNeurosurgery Department, Principal Military Hospital, Dakar, SenegalNeurosurgery Department, Principal Military Hospital, Dakar, SenegalCervical dystonia is the most common focal dystonia affecting adults. It frequently causes postural control problems, neck pain and spasm attacks of the cervical musculature. One of the surgical options available is selective cervical denervation. We report the case of a 32-year-old patient with cervical dystonia refractory to conservative treatment and an injection of botulinum toxin A, which was finally completed by bilateral selective cervical denervation, with considerable regression of cervical spasm at 16 months post-operatively.The clinical presentation of cervical dystonia includes abnormal movements or postural changes of the head, neck and shoulders caused by involuntary contractions of the cervical muscles. When the spasmodic attacks are recurrent, they can cause real handicaps for the patient. The causes of the disease and its pathophysiological mechanism are still poorly understood. There are a number of treatment options, including pharmacological therapy and surgery in cases of therapeutic failure. Repeated intramuscular injections of botulinum toxin are the first-line treatment. Some conservative measures such as physiotherapy are also used, although there is little literature on these approaches.Selective peripheral denervation is currently the main surgical treatment for refractory cervical dystonia. A combination of conservative treatment with BT-A injection and denervation appears to be an effective treatment option.http://www.sciencedirect.com/science/article/pii/S2214751923001792Cervical dystoniaRefractoriesDenervation |
| spellingShingle | Hugues Ghislain Atakla Abdou Aziz Diop Ibrahima Tine Basse Sall Thomas Kofi Dakurah Sagar Diop Aristide Donyo Coumba Saar Pape Sandène Ndiaye Alioune Badara THIAM Momar Code BA Refractory cervical dystonia, unresolve issue and therapeutic challenge: Follow-up of a case with surgical denervation combined with conservative treatments Interdisciplinary Neurosurgery Cervical dystonia Refractories Denervation |
| title | Refractory cervical dystonia, unresolve issue and therapeutic challenge: Follow-up of a case with surgical denervation combined with conservative treatments |
| title_full | Refractory cervical dystonia, unresolve issue and therapeutic challenge: Follow-up of a case with surgical denervation combined with conservative treatments |
| title_fullStr | Refractory cervical dystonia, unresolve issue and therapeutic challenge: Follow-up of a case with surgical denervation combined with conservative treatments |
| title_full_unstemmed | Refractory cervical dystonia, unresolve issue and therapeutic challenge: Follow-up of a case with surgical denervation combined with conservative treatments |
| title_short | Refractory cervical dystonia, unresolve issue and therapeutic challenge: Follow-up of a case with surgical denervation combined with conservative treatments |
| title_sort | refractory cervical dystonia unresolve issue and therapeutic challenge follow up of a case with surgical denervation combined with conservative treatments |
| topic | Cervical dystonia Refractories Denervation |
| url | http://www.sciencedirect.com/science/article/pii/S2214751923001792 |
| work_keys_str_mv | AT huguesghislainatakla refractorycervicaldystoniaunresolveissueandtherapeuticchallengefollowupofacasewithsurgicaldenervationcombinedwithconservativetreatments AT abdouazizdiop refractorycervicaldystoniaunresolveissueandtherapeuticchallengefollowupofacasewithsurgicaldenervationcombinedwithconservativetreatments AT ibrahimatine refractorycervicaldystoniaunresolveissueandtherapeuticchallengefollowupofacasewithsurgicaldenervationcombinedwithconservativetreatments AT bassesall refractorycervicaldystoniaunresolveissueandtherapeuticchallengefollowupofacasewithsurgicaldenervationcombinedwithconservativetreatments AT thomaskofidakurah refractorycervicaldystoniaunresolveissueandtherapeuticchallengefollowupofacasewithsurgicaldenervationcombinedwithconservativetreatments AT sagardiop refractorycervicaldystoniaunresolveissueandtherapeuticchallengefollowupofacasewithsurgicaldenervationcombinedwithconservativetreatments AT aristidedonyo refractorycervicaldystoniaunresolveissueandtherapeuticchallengefollowupofacasewithsurgicaldenervationcombinedwithconservativetreatments AT coumbasaar refractorycervicaldystoniaunresolveissueandtherapeuticchallengefollowupofacasewithsurgicaldenervationcombinedwithconservativetreatments AT papesandenendiaye refractorycervicaldystoniaunresolveissueandtherapeuticchallengefollowupofacasewithsurgicaldenervationcombinedwithconservativetreatments AT aliounebadarathiam refractorycervicaldystoniaunresolveissueandtherapeuticchallengefollowupofacasewithsurgicaldenervationcombinedwithconservativetreatments AT momarcodeba refractorycervicaldystoniaunresolveissueandtherapeuticchallengefollowupofacasewithsurgicaldenervationcombinedwithconservativetreatments |